Comparison of the Effects of Quadratus Lumborum Block and Retrolaminar Block on Postoperative Pain in Lumbar Disc Herniation Surgery

Comparison of the Effects of Quadratus Lumborum Block and Retrolaminar Block on Postoperative Pain in Lumbar Disc Herniation Surgery

This study aims to compare the analgesic efficacy of quadratus lumborum block (QLB) and retrolaminar block (RLB) in patients undergoing lumbar disc herniation surgery. Both regional anesthesia techniques are increasingly used for postoperative pain management, but there is limited evidence directly comparing their effectiveness. The primary outcome is the postoperative pain score, while secondary outcomes include opioid consumption and patient satisfaction.

Effective postoperative pain management is essential in patients undergoing lumbar disc herniation surgery. Regional anesthesia techniques, such as quadratus lumborum block (QLB) and retrolaminar block (RLB), have been increasingly used as alternatives or adjuncts to systemic analgesics. QLB provides analgesia by targeting the thoracolumbar fascia and spreading to the paravertebral space, whereas RLB is considered a simpler and potentially safer approach with similar analgesic potential.

This randomized controlled clinical trial is designed to compare the efficacy and safety of QLB and RLB for postoperative pain control. Adult patients scheduled for elective lumbar disc herniation surgery under general anesthesia will be randomized into two groups. One group will receive ultrasound-guided QLB, and the other group will receive ultrasound-guided RLB before surgical incision.

The primary outcome is postoperative pain intensity measured using a numerical rating scale (NRS) at multiple time intervals within the first 24 hours after surgery. Secondary outcomes include total opioid consumption, time to first analgesic request, incidence of block-related complications, and overall patient satisfaction. The results of this study are expected to provide evidence for the optimal regional technique for postoperative analgesia in lumbar spine surgery.

Inclusion Criteria:

Patients aged 18-65 years American Society of Anesthesiologists (ASA) physical status I-II-III Scheduled for elective lumbar disc herniation surgery under general anesthesia Willing to participate and provide written informed consent Patients scheduled for elective lumbar disc herniation surgery

Exclusion Criteria:

Patients requiring emergency surgery ASA physical status classification IV-V Known coagulopathy Ongoing anticoagulant therapy History of allergy to local anesthetics Localized infection at the block injection site Presence of spinal, paraspinal, or regional deformities at the block area Inability to understand or use the verbal pain rating scale Chronic use of analgesic medications